| Doctor Name: | SUSAN JANE ERICKSON |
| NPI Number: | 1326390527 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. CCC SP |
| License Number: | LL00001533 |
| Business Practice Address: | 305 N. 6th La Conner, WA - 98257 |
| Business Phone Number: | 3604663171 |
| Business Fax Number: | 3604663523 |
| Mailing Address: | P.o. Box 2103, LA CONNER |
| State: | WA |
| Postal Code: | 98257 |
| Phone Number: | 3604663171 |
| Fax Number: | 3604663523 |
| NPI Enumeration Date: | 10/11/2012 |
| NPI Last Update Date: | 10/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | LL00001533 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |